10-0731 (RC)1y=,• ��
P.O. BOX 1504 4VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/25/10
Application Number: 10-00000731 Owner:
Property Address: 79785 HIGHWAY 111 STE 101 KOMAR INV
APN: 600-020-034- - 23 CORPORATE PLZ STE 24710
. -
Application description: REMODEL - COMMERCIAL NEWPORT BEACH,'CA 92660
Property Zoning: COMMERCIAL PARK 3Application valuation: 5000 20,� j
Contractor: LrTY OF iA QUiNTA
Applicant: Architect or Engineer: K M S CONSTRUCTION SERV L RIVA.Z+CE s)E-T
23 CORPORATE PLAZA, #247'
NEWPORT BEACH, CA 92660
(949)718-4844
jCOM 1�1� Lio. No.: 932143 ---n _
------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: /B-C10License N .: 932143
Date:�/t ^ Contractor: Py'�
I' --77Z;;- .77/!!// OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031.5. Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by '
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 1 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
1 _ I I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name: _
Lender's Address:
LQPERMIT
-----------------------------------------------—
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
1 have and -will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier ZURICH INS Policy Number 486597004
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
1� ) 37%00 of the Labor Cade, I shall forthwith comply
�with
�—those provisions.
carate: �./i�lrlPPlicant:
Od-1 16
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT '
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1 . Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that 1 have read this application and state that the above information is correct. I agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives
of this county to enter upon the above-mentioned property fo insppeyection purposes.
ltDate:,� Signature (Applicant or Agent):
Application Number . . . . . 10-00000731
------ Structure Information ADD UNISEX TOILET FACILITY SHELL IMPROV -----
Other struct info . .
. . . CODE EDITION
2007/2008
FIRE SPRINKLERS
FULLY
MIXED-USE OCCUPANCY
M/B
OCCUPANT LOAD
.00
----------------------------------------------------------------------------
1ST FLOOR SQUARE FOOTAGE
2824.00
Permit . . .
BUILDING PERMIT
Additional desc .
Permit Fee . . . .
72.00 Plan Check Fee
46.80
Issue Date . . . .
Valuation . .
. . 5000
Expiration Date
2/15/11
Qty Unit Charge
Per
Extension
BASE FEE
45.00
3.00 9.0000
----------------------------------------------------------------------------
THOU BLDG 2,001-25,000
27.00
Permit . . .
ELECT - ADD/ALT/REM
Additional desc . .
Permit Fee . . . .
17.25 Plan Check Fee
4.31
Issue Date . . . .
Valuation
0
Expiration Date
2/15/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
3.00 .7500
------------------------------------------------------------'----------------
PER ELEC DEVICE/FIXTURE 1ST 20
2.25
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
19.50 Plan Check Fee
4.88
Issue Date . . . .
Valuation
. . 0
Expiration Date
2/15/11
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1.00 4.5000
----------------------------------------------------------------------------
EA MECH VENT INST/ DUCT ALT
4.50
Permit PLUMBING
Additional desc
Permit Fee . . 30.00
Issue Date
Expiration Date 2/15/11
Qty Unit Charge Per
LQPERMIT
Plan Check Fee 7.50
Valuation . . . . 0
Extension
Application Number .. . . . . 10-00000731
Permit . . . . PLUMBING
Qty Unit Charge Per
Extension
BASE FEE
15.00
2:00 6.0000 EA PLB FIXTURE
12.00
1.00 3.0000 EA PLB WATER INST/ALT./REP
3.00
----------------------------------------------------------------------------
Special Notes and Comments
SHELL IMPROVEMENT - ADD ADDITIONAL
UNISEX TOILET FACILITY TO EXISTING
TENANT SPACE.101. 2007/2008 CALIFORNIA
BUILDING CODES.
August 19, 2010 5:19:00 PM AORTEGA
-----------------------------------------------------------------------------
Other Fees -. . . . . . . ACCESSIBILITY PLAN REVIEW
4.68
BLDG STDS ADMIN (8B1473)
1.00
ENERGY REVIEW FEE
4.68
Fee summary Charged Paid Credited
---------------------------------------------------------
Due
Permit Fee Total 138.75 .00 .00
138.75
Plan Check Total 63.49 .00 .00
63.49
Other Fee Total 10.36 .00 .00
10.36
Grand Total 212.60 .00 .00
212.60
0
LQPERMTT
II
II
I'
�soJACENT 1
PROPERTY 11
NOT A PART
(I
II I
o JI I.
I I .
79=765
G
79.14.4 Hwy 1
79415 Hwy 111
A
��� :::: I 1 1
' �� Lt
I I',i,I
COSTCO �
WFIOLESl1 LE '
] ON,
ADJACENT
PROPERTY
NOT A PART
ADDRESSING SUM
Building "A" - 79-815
Building "B" - 79.825
(includes Suites 10
Building "C" - 79435;
(Includes Suttee 10
Building "D" .70-M 1
(Includes Sultes 10
Building "E" - 79-7851
(Includes Suites 10
Building "F"'- 79.7751
(Includes Suites 10
sout+ll
Building "G" - 79-765
Building "H" -79.71M
f
(Includes Suites 10
Building'J" - 79-7051
John R. Hawkins
Fire Chief
Proudly serving the
unincorporated
areas of Riverside
County and the.
Cities of:
Banning
e.-
Beaumont
.Beaumont
Calimesa
Canyon Lake
4.
Coachella
4.
Desert Hot Springs
11 o•
Indian Wells
Indio
Lake Elsinore
La Quinta
Moreno Valley
Palm Desert
Perris
4.
Rancho Mirage
Rubidoux CSD
San Jacinto
Temecula
Board of Supervisors
Bob Buster,
District I
John Tavaglione,
District 2
Jeff Stone,
District 3
John Benoit,
District 4
Marion Ashley,
District 5
RIVERSIDE COUNTY
FIRE DEPARTMENT
In cooperation with the
California Department of Forestry and Fire Protection
77-933 Las Montanas Rd STE 201, • Palm Desert, CA 92211 • (760) 863-8886 • Fax (760) 863-7072
August 12, 2010
RE: TENANT IMPROVEMENT PLAN CHECK
LAQ-IO-TI-025 Komar Desert Ctr. 79-785 Hwy 111 #102 La Quinta, CA
You have been issued a release for a tenant improvement on an existing building. THIS IS NOT AN
OCCUPANCY PERMIT.
THE FOLLOWING CONDITIONS MUST BE MET PRIOR TO INSPECTION:
A minimum 2AIOBC Fire Extinguisher, (State Fire Marshal Approved) must be mounted in a visible
location within 75' walking distance from any point in your building or suite. Fire extinguishers can
be installed by a licensed extinguisher company with a State Fire Marshal service tag attached to the
extinguisher, or purchased from a retail store with a sales receipt attached. A licensed fire extinguisher
company must service extinguisher yearly. ,
All breakers must be labeled and a clearance of 36 inches must be maintained around the panel at all
times.
As may be necessary to maintain proper fire sprinkler protection due to constructions changes, fire
sprinkler system plans for the tenant improvement area are required to be submitted to the Fire
Department for review.
Applicant/installer shall be responsible to contact the Fire Department to schedule inspections. A re-
inspection fee will be required if more than one (1) inspection is necessary. Requests for inspections
are to be made at least 72 hours in advance and may be arranged by calling (760) 863-8886.
All questions regarding the meaning of these conditions should be referred to the Fire Department
Planning & Engineering Staff at (760) 863-8886.
Sincerely,
Jason Stubble
Fire Safety Specialist
APPLICATION # AlbDRE TflzAw i4.8
.!4c. lot y
VALUATION SQ. PIT.
�lst-:FLOOR.
2:nd. FLOOR
COVERED PATIO'.
..GARAGE.
TYPE. CONST.:.
'OCCUPANCY.
A/C
FIRE . -SPRINKLER
# OF BEDROOM
FLOOD. ,ZONE
.-
'OF''.,UNIT--S*:: (J)
CODE EDITION
ROOF TYPE
MECHANICAL
# VENT FANS
# EXHAUST HOOD
A/C -<3 TON
A/C >3 TON
FAU <100,000 BTU
FAU. >100,000 BTU
DUCT ALTERATION
UNIT COUNTS /..;GAS
CDD APPROVAL
ENGINEER APP.
Bi
City of La Quinta
Building 8z Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
I� 3
Project Address: '7'95 I` 1 0
Owner's Name: Ko r4Aa- DE-9g(zr
S . LL
A. P. Number: — Q� _ r3
Address: 23 0a2P,) (24-7E peAZoa So / 9`�, 2
Legal Description:
Contractor: kp►AILIIL
City, ST, Zip: pjjVP0AP- DC -Al,
telephone:6? 9-
Address: 'Z3, d9a-,Pp
R -A Z A
Project Description:
City, ST, Zip: 1.V1 %
91-1 4 MOUrG�l
tC, U
Telephone q �`�' 7t�2E-
S9490M TO golT�1-
I (JB.-,
State Lic. # 1/13
City Lic. #;
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
•• ; :
Construction Type: M Occupancy:
Project type (circle one): New Add, n
I/(,l .
Repair Demo
State Lic. #:
Name of Contact Person: ��,
Sq. Ft.: S
# Stories:
# Units:
Telephone # of Contact Person: 019 - - 7-53 -0 qO
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRA PERMIT FEES
Plan Sets
Plan Check submitted Item
Amount
Structural Calcs.
Reviewed, ready for corrections Plan Check Deposit
�—
Truss Calcs.'
Called Contact Person Plan Check Balance
Tide 24 Coles.
Plans picked up Construction
Flood plain plan
Plans resubmitted Mechanical
Grading plan
2id Review, ready for corrections/Issue Electrical
n-257
1�
Subcontactor List
Called Contact Person Plumbing
3�
?•
Grant Deed
Plans picked up S.M.I.
^
H.O.A. Approval
Plans resubmitted Grading
IN HOUSE:
'"' Review, ready for correction&4wue Developer Impact Fee
Planning Approval
Called Contact Person A.I.P.
�-
Pub. Wks. Appr
Date of permit issues
School Fees
I,* ('Vo . To
P'
Total Permit Fees
1SsUr-' &,'I
A
c -V . V'VM
sts4"? .